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67 Cards in this Set
- Front
- Back
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The profession of counseling came into age in...
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The 1980's
-There were more therapeutic approaches -More states passed licensing laws |
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2 Professional Counseling organization
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-American Counseling Association
-American Psychological Association |
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APA
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-Division 17 is the major one for counseling psychologists
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ACA
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-The major organization for counselors
-Journals: Journal for Counseling and Development, and Counseling Today -18 divisions |
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CA CREP
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Counsel for Accreditation of Counseling and Related Education Programs
-ACA created it -8 Core areas |
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NBCC
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National Board of Certified Counselors
-Founded by the APGA (American Personnel and Guidance Association) -NCE test |
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Certification
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NBCC 6 areas of certification
-Career counselor -Gerontological Counselor -School Counselor -Mental health counselor -Community counselor -Addictions Counselor States offer specialty certifications for specific settings as well |
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Licensure
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Legal status for counseling, protecting the public and profession
-Depends on state laws -46 states have licensing laws for counselors -Different from certification in that it: enables counselor to practice independently Is required for third party payment Is regulated by state licensing boards -Has extensive training/education requirements - |
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Codes of Ethics purpose
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-Created by professional organizations and licensing boards
-protects the client -Educates members on professional conduct -enhances public trust -Accurately enforces standards -etc |
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Two levels of Ethics
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-Mandatory:compliance with minimal standards of law/ethic codes
-Aspirational:demonstrating the spirit behind the code, the principles, doing ones very best for the client |
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ACA Code
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-on its fifth revision since 1961(about every 10 years)
-2 documents: The Standards of Practice (focus on mandatory), and The Codes of Ethics (focus on ideals) |
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Code of Ethics Summary- A
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The Counseling Relationship
-Counselor's primary responsibility is to respect clients dignity and promote their welfare -Addresses issues of discrimination, disclosure, dual relationships, sexual intimacies w/ clients, fees/bartering, abandonment, termination and computer tech |
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Code of Ethics Summary- B
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Confidentiality
-Respecting clients right to privacy, avoid illegal/unnecessary disclosure -Addresses issues of limitations of confidentiality, group/family situations, record keeping, reporting or research, record disclosure/transfer, supervision, and consultation |
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Code of Ethics Summary- C
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Professional Responsibility
-Competence in practice; including reading, understanding, and following Code of Ethics and Standards of Practice -Boundaries of competence, proper training/supervision, monitoring effectiveness, continuing education, not practicing if impaired, accurate advertising, respect for other professionals |
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Code of Ethics Summary- D
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Relationships with Other Professionals
-Counselors clearly defining their roles and working agreements with other professionals -work conditions, evaluations, development of self/staff, selection of staff, professional conduct, consultation, subcontractor arrangements, fees for referrals, and acceptance of a fee from a client |
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Code of Ethics Summary- E
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Evaluation, Assessment, and Interpretation
-Competence in administering and interpreting assessment instruments they have been trained for. -Use of assessment instruments, limits of competence, getting informed consent, choosing instruments, and reporting of results |
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Code of Ethics Summary- F
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Teaching, Training, and Supervision
-Counselor who teach/supervise should be skilled -Boundaries with students, sexual relationships with students, teaching and supervision competence, education/training program development, eval, and dual relationships |
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Code of Ethics Summary- G
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Research and Publication
-Counselors design, conduct, and report research consistant with ethical principles, etc -Informed consent, precautions to avoid injury, confidentiality, accuracy in reporting, other issues related to research with humans |
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Code of Ethics Summary- H
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Resolving Ethical Issues
-Counselors should know the Code and Standards and take appropriate action if violations occur -Reporting violations by colleagues, consulting with counselors about difficult ethical situations, unwarranted complains, resolving ethical conflicts, cooperating with ethics committees |
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Scope of Practice
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An area where one is recognized to be proficient in.State licensing usually specify
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Advantages of Private Practice
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-Autonomy
-Client follow-through -Caseload Control |
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Disadvantages of Private Practice
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-Fluctuating income
-Isolation -Multiple responsibilities for providing client care and business running |
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4 typical business structures
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-Sole proprietorship
-Partnership -Corporation -Nonprofit Corporation |
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Sole Proprietorship
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-Most private practices are this
-Individual owns the practice, and only they have financial interest in it. -Simple, maybe the best |
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Partnership
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-Second most popular
-A lot of issues can arise, including: Total agreement on decisions needed each partner is liable for acts of the other presumption of equality exists for liabilities and profits personal assets not protected from business debts Dissolution of partnership can be contentious and expensive |
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Group Practice
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anything from a bunch of private practice counselors sharing office expenses, to a little more complicated.
brings a social aspect without partnership issues |
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Corporations
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-Complicated, affected by legislation and tax laws
-Advantage is to protect personal assets if business should fail -Advantages: accumulation or assets, transferability of ownership, flexible fiscal year, employee benefits, some liability reduction, management structure |
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Non-Profit Corporations
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-Favorable tax laws and eligibility of certain grants
-Pay ones self salary from the corporation but have no ownership. -Board of directors must be established to qualify The board has power to assert their own interests, and can remove or replace anyone and take over the business |
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Sliding scale fee structure
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establishes the fee based on amount of income the client generates or the size of family or something else objective.
If this is chosen, it must be applied to everyone. |
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Managed Care
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Limits services to lower cost of health care
-limits treatment to only what wil enable client to function at a reasonable level, and some preventative services |
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Forms of Manged Care
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-Health Maintenance organizations (HMO's), uses restricted group of providers, specified services at specified costs
-Preferred Provider organizations (PPO's) purchase services from specific providers at reduced rate -Independent Practice associations (IPA's) allow consumers to choose independent practitioners to see them in their offices rather than in HMO facility |
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Payment from Managed Care plan
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-Must be on their provider list, thus must meet standards
-One must follow the company's policies carefully, and demonstrate efficacy to stay on the list and receive referrals |
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Advantages of Managed Care
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-Limited cost of services compared to traditional health insurance
-increased access to mental health services -no exclusion due to pre-existing condition -Establishment of quality control and monitoring of standards of practice |
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Disadvantages of Managed Care
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-Limited choice in providers
-inability to consult a specialist directly -reduction in the variety of services available -potential overuse of medication -limited treatment duration |
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Ethical Issues
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-Upcoding a diagnosis to something more serious to get more sessions
-Downcoding a diagnosis to something the managed care company will reimburse -prematurely terminating with a client because managed care won't pay for more sessions -Other: client abandonment, confidentiality, informed consent, and requirement of diagnosis |
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You should use attorneys for
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-forming a partnership
-signing a lease for office space -receiving a subpoena to release records when client doesn't want them released -A health insurance comapany denies client claims because they don't believe you provided services -Dissolving a partnership |
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Professional Ethics
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Agreed upon standards that define what is good and ideal practice for that profession
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Ethical Concerns: Competence's
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-Ethical and legal concept
-counselors meeting minimum standards of performance to practice -Also, striving for the maximum level of knowledge and skill |
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Common limits to confidentiality
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-child/elder abuse
-intent to harm -counseling minors -The counselor is under supervision -Counseling is under court order -Client consents to disclosure -clerical assistants handle client info -coordinating treatment with other professionals -client filing complains against counselor -criminal action is involved |
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Duty to Warn/Protect
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-Identifying clients likely to do physical harm to third parties
-Protecting third parties from clients judged potentially dangerous -Treating clients who are dangerous |
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Tarasoff v. Regents university of California
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-college girl killed by boyfriend, who had told psychologist. However, campus police didn't do enough.
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Dual/multiple Relationships
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Being a counselor as well as some other type of non-professional relationship
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Informed Consent
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-Respect of client autonomy requires that clients know about treatment
-Therapeutic process -Background -Costs of treatment -Length of treatment -Benefits and risks -nature and purpose of confidentiality |
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Record keeping
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-should be kept for client and counselors good
-record belongs to the client, but the counselor keeps it - |
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Technology
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Electronic storage of client materials, transition of client information, computer assisted, internet
-reminders for ethical use: -Same safeguards used for printed and electronic media -privacy protocols -careful control of fax -e-mail isn't confidential -cell phones not confidential |
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Buckley Amendment
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The Family Educational Rights and Privacy Act (FERPA)
Gives parents of minors and students 18+ -The right to access educational records by institution -Prevention of institution releasing info to third party without written consent |
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Expert Witness Testimony
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Counselors are increasingly appearing in court as expert witnesses
-The only witness allowed to express his/her own opinion Tips: -prepare well -be able to justify your conclusions -know strengths and weaknesses of an assessment instrument used -listen carefully to questions asked and answer concisely -speak clearly -avoid jargon -be professional in appearance and presentation |
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Individuals with Disabilities Education Act (IDEA)
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requires education institutions to provide the least restrictive environment possible to students regardless of degree of handicap
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Libel/Slander
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Making false verbal or written statements about another professional that would damage their reputation can be charged with this.
-Called Defamation, if written it is libel if spoken is slander |
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Malpractice/Negligence
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Professional liability: refers to the responsibility and legal practice of a profession. If they fail,
-Malpractice: this is not rendering the appropriate services so that the client ends up with loss or injury |
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Professional Negligence
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occurs when the counselor departs from the ordinary or fails to exercise due care,
-Common: violations of confidentiality, sexual misconduct, failure to prevent suicide, other incompetence allegations |
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TO succeed in malpractice claim these 4 must be present
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-A professional relationship was established between the counselor and client (duty)
-Counselor was negligent or deviated from the "standard of care" (breach of duty) -Client suffered harm/injury, can be demonstrated (injury) -A causal relationship exists between the negligence of the counselor and the harm claimed by the client |
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Privacy
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This is a right to keep certain information concealed
Includes: -Disposal of records -Recordings -Not being identified in the waiting room -Credit card info for billing -Computer scoring services -Others |
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Privileged Communication
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Protect clients fro having confidential info disclosed in a court without permission. State statutes define what kinds of info is privileged and what category of professionals can assert privilege
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Protection of Human Participants
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The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was created to protect people.
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Subpoenas
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Official court documents that may require the counselor to:
-Produce copies of records -Appear for a deposition, court hearing, or trial -Appear and bring their records with them (pubpoena duces tecum) |
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Tort
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a civil, rather than criminal, wrong. Harm done to someone requiring the person who inflicted to pay damages. Can be unintentional, like with malpractice, or intentional, as of batter, defamation, invasion of privacy, or infliction of mental distress
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General Ethical Decision Making- Autonomy
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Clients make their own choices. Counselors shouldn't strive for dependence from their clients
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General Ethical Decision Making- Beneficence
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-Doing what is good and helpful for clients. All things should be considered, and assume the client probably does know best
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General Ethical Decision Making-Non-maleficence
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Do no harm
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General Ethical Decision Making- Justice
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Being fair and nondiscriminatory
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General Ethical Decision Making- Fidelity
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Relationship is based on trust, keeping ones promises and honoring commitments is important
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Theories of Ethical Reasoning-
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-Utilitarianism
-Formalist |
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Utilitarianism
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Ethical obligation based on the "rightness" or "wrongness" of an action depending on the "goodness" or "badness" of the consequences. Thus, a decision is made based on the action producing the best consequences for the most number of people
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Formalist
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Developed by the rationalist philosopher Immanuel Kant
-One can formally determine how moral an act is through a test of the "categorical imperative." Basically, if everyone did the action, would a rational person want to live in a world like that. |
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When facing ethical dilemma's look at
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Principles of autonomy, beneficence, nonmalificience, justice, fidelity, and veracity
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8 Steps for Ethical Decision Making
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-Identify the problem
-apply the ACA Code of Ethics -Determine the nature and dimensions of the dilemma -Generate potential courses of action -Consider the Potential consequences of all options -Choose a course of action -Evaluate the selected course of action -Implement the course of action |
